The Kidney Following Cardiac Surgery

Abstract

The kidneys receive one quarter of the cardiac output: it is therefore hardly surprising that impairment of renal function is a major complication of cardiopulmonary by-pass surgery (CPBS) with a high mortality, both in adults and children (1). The principal cause is undoubtedly renal hypoperfusion resulting from a low cardiac output, but other factors may be additive: before surgery there is to consider the physiological characteristics of the neonatal kidney and the questions of congenital renal abnormality, cyanotic nephropathy and the nephrotoxicity of radiological contrast media; during CPBS there is the possible effect of haemolysis; and subsequently there may be septicaemia or drug nephrotoxicity (particularly antibiotics).